Diabetic foot complications result in over 67,000 lower extremity amputations annually and cause more hospitalizations than any other single complication of diabetes. Foot wounds precede 84% of these amputations and usually occur when patients with diabetes have peripheral neuropathy and cannot feel foot trauma from ground-reactive (shock) and shearing (friction) forces. This loss of sensation presents a footwear challenge - to prevent wounds - current technologies don't adequately address. Currently, the most effective method for preventing foot wounds involves (1) custom molded shoes or (2) extra-depth, extra-width shoes; both with three sets of custom orthoses annually. These orthoses are expected to counteract both shock and friction, but are insufficient. These options have serious fit and availability limitations, and significant material and labor costs. Jointly with Z-Coil, Inc. of Albuquerque, MedEffciency poses to develop the Circumferential Neuropathic Foot Protection System (CNFP) - an extra-depth, extra-width protective shoe with a custom orthosis. The shoe's patented spring technology absorbs shock, while its silicone custom orthosis minimizes friction. Utilization should increase with the ability to customize and dispense immediately with lower cost than present alternatives, resulting in fewer foot wounds, fewer amputations, reduced healthcare costs and higher quality of life for patients with diabetes. PROPOSED COMMERCIAL APPLICATIONS: In the U.S. alone, there are estimated to be over 16 million people with diabetes, with at least one-third undiagnosed. There are over 67,000 diabetic amputations each year, but the majority are avoidable with proper intervention to prevent foot wounds. Proper footwear for these patients is absolutely essential for wound prevention. If the CNFPS could capture just 10% of the high-risk market for diabetic footwear, it would generate revues in excess of $70 million each year based on Medicare reimbursement rates, while still significantly reducing total healthcare costs.